Shelley Barker Email and Phone Number

 Assist on multiple Product Development projects to complete Summary of Benefits & Coverage, PMT matrices and Schedules of Benefits in compliance with Health & Human Services and Health Care Reform requirements and deadlines Individual Under 65 Testing Lead for the new SBC User Interface tracking and reporting results in coordination with the Small and Large Group teams, IT and Product Management Audit and review contract, booklets, schedules and other member documentation for errors… Show more  Assist on multiple Product Development projects to complete Summary of Benefits & Coverage, PMT matrices and Schedules of Benefits in compliance with Health & Human Services and Health Care Reform requirements and deadlines Individual Under 65 Testing Lead for the new SBC User Interface tracking and reporting results in coordination with the Small and Large Group teams, IT and Product Management Audit and review contract, booklets, schedules and other member documentation for errors and inconsistencies prior to submission to the Office of Insurance Regulation Analyze Health Care Reform SHOP/Exchange Rules to identify all applicable requirements for Product Development and Contracts Show less

 Responsible for development of usable business requirements while identifying improvement/enhancement opportunities to the existing process Facilitated weekly project status meetings with all participating team members in a Project Management capacity to ensure deadlines were met, issues were addressed and maintain compliance Researched project performance and system issues to identify and determine resolution then followed thru with develop and implementation Communicated with… Show more  Responsible for development of usable business requirements while identifying improvement/enhancement opportunities to the existing process Facilitated weekly project status meetings with all participating team members in a Project Management capacity to ensure deadlines were met, issues were addressed and maintain compliance Researched project performance and system issues to identify and determine resolution then followed thru with develop and implementation Communicated with stakeholders to obtain their approval prior to testing and again prior to production Accountable for the analysis, development, testing, implementation and results of multiple projects Show less

 Managed the off-phone activity for 250 reservation agents including the scheduling of all training Maintained staff tracking databases for attendance, schedule adherence and staff forecasting Trained new employees on all operational processes and documentation

 Reviewed process results reports for both one-time and multi-use process to confirm accuracy and to locate opportunities for continuous improvement Researched both claims and provider contract issues to determine if an error occurred, the cause of the error and if the resolution could be automated Provided input during contract negotiations with both physicians and facilities Conducted weekly conference calls with market staff and provided summary reports to… Show more  Reviewed process results reports for both one-time and multi-use process to confirm accuracy and to locate opportunities for continuous improvement Researched both claims and provider contract issues to determine if an error occurred, the cause of the error and if the resolution could be automated Provided input during contract negotiations with both physicians and facilities Conducted weekly conference calls with market staff and provided summary reports to management Selected to participate in pilot of new contract system and facilitated training of claims and customer service staff Show less